Individual provider Active NPI

Matthew W Elchin, PA-C

  • Physician Assistant
  • Johnstown, PA
National Provider Identifier
1700854221
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051064 Issued in PA
Practice address
1086 Franklin St
Johnstown, PA 15905-4305
Phone
(814) 539-5987
Fax
(814) 535-4176
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA051064 PA Primary

Addresses

Primary practice location

1086 Franklin St
Johnstown, PA 15905-4305

Mailing address

239 Main St
Suite 400
Johnstown, PA 15901-1640
Phone (814) 539-5987

Other identifiers 2

IdentifierTypeStateIssuer
1956773OtherPAHIGHMARK BC BS
07822620MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120508000360 PA Practitioner - Physician Assistant 8820250830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cambria Somerset Radiology and Nuclear Medicine Group IncGroup PAC ID 7113824277, 38 clinicians

Practice addresses (Care Compare)

1086 Franklin St
Johnstown, PA 15905-4305
Phone (814) 536-7226

Hospital & facility affiliations

  • Conemaugh Memorial Medical Center Hospital, Johnstown, PA, CCN 390110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Consultants Inc Current Accepting new patients
Windber Hospital, Inc. Past Accepting new patients

Locations

350 Southmont Blvd
Johnstown, PA 15905
Phone (814) 535-2511

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1700854221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 MAIN ST",
            "address_2": "SUITE 400",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159011640",
            "telephone_number": "814-539-5987",
            "fax_number": "814-535-4176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 FRANKLIN ST",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159054305",
            "telephone_number": "814-539-5987",
            "fax_number": "814-535-4176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELCHIN",
        "first_name": "MATTHEW",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BC BS",
            "identifier": "1956773",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07822620",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnstown, PA

Sources for this page

Verify at the official NPI Registry.